Teddy P – Wiltshire, Southwest England, United Kingdom
Male, Somali Cat
April 27, 2001 – July 2, 2015
Diagnosed with moderate to severe IBD on May 1, 2005
Diagnosed with focal seizure as a form of epilepsy on February 2, 2012
Diagnosed with iris rubinosis and suspected chronic uveitis related to IBD on March 30, 2012
Diagnosed with Renal Lymphoma June 30, 2015
First Entry, April 21, 2011: I collected Teddy from a breeder at 5 months old. He was initially fed on Iams dry kibble kitten food, then changed to Whiskers canned Kitten food, before progressing to Felix and Whiskers canned adult food and kibble, which he was fed on until diagnosed with IBD in May 2005. Prior to diagnosis in May 2005, Teddy had been a member of a multi cat house hold. I was the proud owner of four beautiful cats, all different breed types, colors and within various range of ages, none of which were related. Ellie, a beautiful long haired tortoiseshell mixed breed domestic cat who was euthanized in July, 2004 after being diagnosed with un-treatable cancer of the stomach at 14 years of age. Gismo, a beautiful silver tabby and white chinchilla Persian cross moggy cat. And Lulu, a silver Somali, (see Lulu’s case history in living with IBD). Teddy had shown a tendency to occasional and sporadic boats of vomiting and diarrhea which usually responded well to courses of Claveseptin and metronidazole. Although retrospectively, Teddy had been subject to very loose toilet and had vomited from an early age. I remember he had diarrhea when I collected him from the breeder, but thought it was probably due to the stress of a long car journey home.
In May 2005 it was decided to give Teddy an X-Ray, endoscopy and gut biopsies to find a definitive cause, and treatment for his condition. Initially, we obtained stool samples over three consecutive days for lab analysis to eliminate the possibility of parasitic and bacterial infections. The results confirmed that Teddy had IBD; he was prescribed 5mg of losec per day and a quarter Antepsin twice daily. A prescription diet of Royal Canin Sensitive Control (SC31) capelin and tapioca kibble was recommended. Teddy was generally treated with Claveseptin and metronidazole and fed lightly boiled chicken during each bout, with slow progression to Royal Canin sensitivity control chicken and rice moist pouch food and kibble. Despite his on going condition, Teddy was generally a happy and sociable cat.
In January of 2009 Teddy was well, but had vomited once a day, usually early morning for 7 out of 9 consecutive days despite being on 10mgs of losec per day, A.M. and Katalax twice a week for fur balls. On the 10th day I started to feed little and often, which resulted in no vomiting. However, his stools become softer with one occurrence of a small quantity of fresh blood dripping from him anus at the end of each stool on the 11th day. The next 7 days continued uneventful, as long as I fed little and often, again one occurrence of fresh blood dripping from him anus at the end of each stool. The vet prescribed ¼ metronidazole twice daily, excellent results. No vomiting or blood from anus but by the end of the month he was projectile vomiting once A.M. and once P.M., wheezing and trying to vomit up fur balls. I fed mainly kibble the next two days, roughage to try and help the fur ball through his system, but did not give Katalax because of loose stools. The vet then prescribed 40 Clavaseptin 50 mg tablets one twice daily and he was generally better. Vet then recommended to give katalax as required. Started to use Furminator (de-shedding tool to remove the loose undercoat hair without affecting the top-coat in any way, meaning your pet sheds far less) and Zoom Groomers (removes any loose hair and feels like a soothing massage). Within the next 3 days, Teddy had vomited once daily for 2 days, which included a one inch compact and hard fur ball, and one occurrence of very soft stool with fresh blood dripping from his anus at the end of the stool therefore contacted vet.
Beginning of April, Teddy vomited 5 times within 8 hours, 5 minutes after each meal. Katalax was given after first occurrence of vomiting at 7.30am. Vet consulted, examined and confirmed no obstruction or blockage or lumps found, sore lower abdominal area observed. Fur balls where contributing to the GI problems and inflaming the bowel. Prescribed losec 10mgs x 7 (1/2, once daily) and prednisolone 5mg x 21 (one twice daily) to reduce the inflammation. Advised to continue with the Katalax. Administered the medication and had one more occurrence of vomiting that evening. Within the next 8 days no occurrences of vomiting and one occurrence of fresh blood dripping from Teddy’s anus when he passed a motion. Teddy’s general demeanor was not very good. He was tuckered up, miserable and ran and hid when it was time for his medication. I was very unhappy with the effect prednisolone has on him. Medication had greatly reduced the symptoms, but Teddy was not well on them. He was depressed, lethargic and tucked up. It was horrible to see him like that because he is usually so Tigger-like (fun loving, bouncy and investigating everything I do). Vet prescribed losec 10mg x 14 and Prescribed 5mg x 14 advised to continue with ½ losec and one prednisolone daily.
In mid May, Teddy had very soft stool with fresh blood dripping from him anus at the end of each stool therefore contacted vet, appointment made for May 18th. His symptoms were fresh blood dripping from anus after motion for the past two days. On day of vet appointment, he had vomiting, bubbly sounding chest, generally inactive. Not interested in anything, just wanted to lay quiet, in out-of -way places. Vet prescribed metronidazole x 5 tablets. Blood samples taken, hematology (hl) and pre-op biochemistry (in house) B12/folate (b3).
On June 15th, vet administered Cerenia solution 20ml and prescribed Cerenia 16mg x 4 tablets at ¼ per day for 6 days and prednisolone 5mg x 20. No vomiting but, generally unwell on prednisolone. Recommended to slowly introduce Royal Canin Feline Hypoallergenic food (DR25) advised to slowly increase the amount of (DR25) while reducing the amount of white fish, aiming to be on 100% (DR25) by June 24.
June 22, 2009: I had a vet phone consultation. Teddy had no vomit from start to finish of medication. Three occurrences of splat-type, very soft poo with fresh and dark blood after each motion. We were to continue on losec ½ daily and prednisolone x 1 daily until June 26, then give vet update via phone call. The plan to drop down from 1 x daily prednisolone to 1/2 x daily prednisolone on June 27th. An alternative treatment discussed was Tremandizole, (acts like a steroid) and metronidazole, anti inflammatory, but is neither a steroid or an antibiotic). By then Tedd had no vomit for a week, toilet slightly firmer and a lot less smelly, still has fresh blood dripping from anus when passing a motion, but with possibly less blood. We were to continue with ½ losec and 1 prednisolone daily, reducing to ½ prednisolone daily by the 27th of June. If toilet had not firmed up on new diet of 100% hypoallergenic biscuits, then we needed to increase prednisolone 1 daily again, need to keep checking Ted’s toilet. It was advised to keep Teddy and Lulu on hypoallergenic food for 5 weeks from June 24th (first day on 100%) in order to allow all other food substances to expel from their bodies. This would allow us to see the effect of the new food on their digestive systems and would give us an understanding of possible causes, either food allergy OR idiopathic bought of Inflammatory Bowel Disease.
June 27, 2009: We reduced prednisolone to 1/2 tablet once daily from this morning. Still observing vomit frequency and stool consistency. In early July, vet prescribed losec x 10mg x 10 tablets, Cerenia 16mg x 4 tablets (1/4 daily). Protextin Pro-Kolin paste. End of July, vet prescribed losec x 10mg x 11 tablets (1/2 daily) and 40 x, prednisolone 5mg tablets (1/2 daily), blood samples taken: T4 (total) sample taken, hematology and biochemistry taken. Advised to continue with ½ losec and ½ prednisolone daily. Results received from tests were: T4 result – negative (count of 49 which is the upper end of normal range). Hematology – white and red cell count indicate inflammation in system, enzyme/calcium count good – (a little high) not cause of tremors as low calcium cause tremors. Fats – OK 2.70 (range 0.79 to 3). Protein – OK, artificially raised, potassium and urine – normal. Liver enzymes up at 150 (normally around 125) indicates the livers working hard. Bilirubin, steroid and fatty sample, liver function test okay, pancreatic test okay. Purchased Royal Canin Hypoallergenic food from vet and continued with ½ losec and ½ prednisolone daily. Towards the end of August, vet prescribed 15 x 10mg losec (/2 daily), 5 x metronidazole tablets (1/2 daily), 22 x 50mg Claveseptin tablets, 10 x 100mg Zantac tablets and 2 x 16mg Cerenia (1/4 daily). Was given 1 x cat booster (combination booster including feline leukemia).
October 30, 2009: Contacted specialist of feline medicine at Bristol University. They recommended chlorambucil (Leukeran) as an option for severe IBD, although ideally would really want to be certain about diagnosis before starting that, in terms of it having been a long time since the biopsies were taken and were there small intestinal biopsies taken as well. It would be ideal to know the severity of small intestinal changes before starting this, and also to be sure that he is systemically well by checking routine hematology and serum biochemistry. This would also need to be monitored regularly if using chlorambucil. Given the high rate of concurrent neutrophilic cholangitis and/or pancreatitis, they wanted to ensure that neither of these were possible reasons for worsening GI signs as well. Cats with IBD, unless very severe will also often respond to diet, but it can take a while of varying dietary trials to find one to which they respond. One that they had particular success with in stubborn cases, especially those with LI signs, was Purina. However, if there are moderate to severe inflammatory changes in the intestines, and on systemic problem, then chlorambucil would be a reasonable next step.
There are 2 different protocols that are used: High dose pulse therapy, chlorambucil at 15mgs PO/m2, per day for 4 consecutive days, every 3 weeks. Or Low continuous dose, 2-6 mg/m2 daily (but frequency altered to tablet size as 2mg tablets and should not be split so often ends up dosing every 2 days) depending on weight. This is usually combined with prednisolone but you may be able to use a lower dose. They saw more side effects generally with the higher pulse dose therapy, adverse reactions including vomiting, diarrhea, anorexia, lethargy and leukopenia, but this is relatively rare with chlorambucil. Hematology with a differential white cell count should be monitored monthly initially and if all is okay every 2-3 months thereafter.
November 5, 2009: Teddy was prescribed 5 x 100mg Zitac tablets (1/2 daily) and 2 x 16mg Cerenia (1/4 daily). November 11th samples were taken, pre–op biochemistry. Pancreatic lipase (K9 /feline). Prescribed 10 x metronidazole tablets and 4 x Cerenia 16mg (1/4 daily).
November 24, 2009: Re-examination and hospitalization. Endoscopy was carried out and biopsies taken. Prescribed Zantac 75mg at ¼ tablet (18.75mg) twice daily. Feed bland diet chicken or white fish. Awaited histopathology results.
December 3, 2009: Definitive diagnosis from investigation was moderate to severe IBD with inflammation affecting the whole length of Teddy’s digestive system from beginning to end. No evidence of secondary tumors or thickness of the cell walls. Prescribed 60 x Claveseptin 50mg tablets, one twice daily. End of December, Teddy started to develop a black ear wax in both ears (in fact Gismo and Lulu had too). Vet suspected possible ear mite infection, although very late in season. Retrospect, on reflection, I now believe this to be due to a food intolerance/food allergy, in all three cats. Prescribed 60 x Claveseptin 50mg tablets, one twice daily and Canaural ear drops, two drops twice daily in each ear for 7 days. Every ones bedding washed.
January 1, 2010: Continued with daily dosing of ¼ Zantac, 1 x Claveseptin twice daily and Canaural ear drops x2 (am/pm). Fed Purina Ha and lightly boiled chicken. Regurgitated food at 2.00am and vomited up digested food at 10am, slept most of day. Teddy was generally vomiting on alternate days and had very windy diarrhea. Although he was generally content in himself and playful.
January 28, 2010: Contacted vet, advised to elevate feeding bowl, the height of two house bricks, so that gravity helps stop regurgitation of food and to continue with medication of ¼ Zantac and 1 Claveseptin twice daily. Teddy’s toilet better but not normal on Purina HA and lightly boiled chicken. After only four days on 100% Purina HA and NO chicken the Diarrhea returned but no blood and Teddy was still vomiting on alternative days.
Early February, continued with medication and 100% Purina HA biscuits only. Observed Teddy is much better on Claveseptin that prednisolone, but soft toilet still continues and occasional vomiting despite being on ¼ Zantac and 1 x Claveseptin twice daily. February 26th, on 100% lightly boiled chicken, continue with ¼ Zantac twice daily (am/pm). Toilet much firmer, but still has fresh blood at end of toilet of each motion, vomiting greatly reduced, alternate days. Teddy generally content and happy.
End of March, vet suggested changing from lightly boiled chicken to lightly boiled turkey and Purina HA while continuing with ¼ Zantac twice daily (am/pm). Over the next couple of months we continued with the ¼ Zantac daily and tried various ratios of boiled turkey and Purina HA, working up and down the ratios to 100% turkey and/or Purina HA (Gismo was very ill at this point too).
By the end of June, Teddy had five occurrences of vomit and toilet with fresh blood dripping for his bottom. Soft, mucus and bloody toilet and sporadic vomiting. I decided to stop Zantac for 1 week to see how he was. Teddy was experiencing a more pronounced generalized body/nerve twitch like a nerve tremor (initially thought to be low calcium, but blood tests showed calcium levels to be normal). I felt this was possible side effects of the Zantac. Three days later, ¼ Zantac twice daily reintroduced because Teddy still has tremor and is still vomiting.
June 20, 2010: Continued with ¼ Zantac twice daily (am/pm) and 100% Purina HA biscuits. After the loss of Gismo and the devastating effects of the diseases and treatments on Gismo’s body I have decided to check out alternative, more naturals ways of finding a solution to Teddy’s and Lulu’s health problems. Introduced one Efavet 330 (oil of evening primrose and marine oil) casual daily (Efavet 330 is a known natural anti-inflammatory supplement). Introduced Evian bottled water, instead of filtered tap water today after reading an article on chemicals in our water supply and page 313 of New Choices in Natural Healing for Cats & Dogs by Amy D. Shojai and the Editors of Prevention for Pets. Evian is free from chloride, which can cause bacterial over growth in the digestive process and can cause bleeding in IBD. I had observed a marked improvement in Teddy’s toilet. Perfect toilet for the last 10 days with no blood, no mucus and firm, also less vomiting, It was truly amazing. Introduced Symbiotic D-C capsule once today, a probiotic and prebiotic powder in a capsule to restore the gut microflora. Currently on 100% Purina HA biscuits.
July 11, 2010: Withdrawal of ¼ Zantac twice daily (am/pm) today. Continued with 1 x Efavet 330 once daily and Symbiotic D-C capsule once today and bottled Evian. Introduce Orijen Chicken kibble into Teddy’s diet and continued to reduce quantity of Purina HA biscuits to slowly increase quantity of Orijen to 100% over the next week (7 days). Once on 100% Orijen Chicken kibble, there was a definite reduction in vomiting, toilet became firmer and no fresh blood. Teddy loved the taste of Orijen but I was concerned about feeding dry kibble only and began searching for wet food. July 26th, on 90% Orijen Chicken kibble, started introducing 10% canned wet food Bozita Chicken. Teddy loved the taste of the Bozita (97% pure organic meat with no grain). Perfect toilet, no issues.
August 1s, 2010: Started to introduce ½ (500mg) B12 methylcobalamin (Natural Factors) due to Teddy’s continued tremor, starting with ½ and working up to one tablet daily over the next three weeks. Occasionally loose toilet and vomit, mainly fur balls. On 60% Orijen Chicken kibble, introduced 40% canned wet food Bozita Chicken. Generally very happy and content cat.
August 27, 2010: Continued with ½ (500mg) B12 methylcobalamin (Natural Factors) and gradually increased to one tablet daily. Tremors were greatly reduced, energy levels increased, was very playful, very happy and content, a joy to watch! Continued with 1 x Efavet 330 once daily, bottled Evian, withdrawal of Symbiotic D-C capsule once, because soft toilet. Fed 60% Orijen Chicken kibble and 40% canned wet food Bozita Chicken.
September 1, 2010: Two weeks of perfect toilet to date. Occasional soft toilet prior to this, if feed more Bozita wet food than dry Orijen kibble. Therefore, perfect toilet achieved when fed 50% Bozita and 50% Orijen. However, when soft toilet, no mucus or blood observed, therefore a 100% improvement. Vomiting greatly reduced, generally only vomited when he had fur balls or ate his food too quickly. Had very soft, silky fur, lots of energy, very playful. Very, pleased with the outcome. Teddy’s, a picture of health and a real purr box now.
October 25, 2010: Vet check up and annual boost given. Vet very pleased with Teddy’s general condition. His weight had increased to 6.1 kg, excellent weight for his size and length. Personal choice, I decided to have the general boost, but exclude FeLV (feline leukemia) because Teddy has limited access to a secure garden, therefore does not come into contact with other cats and have read various article about injection site sarcoma. It has been such a battle to get him and all my cats well that I am afraid to introduce more health risks.
January 1, 2011: Continued with 1 (1000mg) B12 methylcobalamin (Natural Factors) daily, bottled Evian, continued mainly with 50% Orijen Chicken kibble and 50% canned wet food Bozita Chicken. Occasionally substitute (twice or three times a week) the Bozita with Ziwipeak veal & fish daily cuisine and/or lightly cooked fresh minced turkey tight meat and chicken liver, served in the cooking water for extra moisture. Toilet perfect, no mucus, no blood. Occasional fur ball vomit, remedied with Katalax. Happy, healthy, playful and loving cat at last.
March 28, 2011: Continued with 1 (1000 mg) B12 Methylcobalamin (Natural Factors) and gradually increased to two tablets daily. Happy, healthy, playful and loving cat and happy care giver too.
August 18, 2011: Took Teddy to see a new vet, a holistic one in Bath, here in the UK. The appointment went well, we saw Nick Thompson for 60 minutes and he charged for 40 minutes. The appointment and assessment was not conventional. Nick let Ted be his usual inquisitive self and just mooch about his office, sitting in his window sill, under tables and desks, boy is Ted nosy!!! Nick was very relaxed and just observed Ted’s behavior, then he examined him and said that his heart was strong and that his intestines felt a lot better than a lot of cats he examines with IBD. They felt smooth and not clumped together, he said his teeth were good too, in fact he said Ted was very good for a cat his age. So I was very please with that. Nick said that I was definitely on the right track with the grain and rice free foods, he called it a gluten free diet. He says that I am 80% there with Ted’s condition and as I have had such good results with the diet, he feels that diet is the best way to treat this. He has also had a 12 month old Somali kitten/cat response very well to the following so he has recommended a diet change as follows:
1. No more dry food
2. Get raw chicken neck minced, wild rabbit minced and white fish, rotate this order, day after day continually e.g. day one = chicken, day two = rabbit, day three = white fish, day four =chicken, etc.
3. Introduce the new food per day over a 10 day period, starting with 10% raw.
4. No B12 for 4 weeks
6. Feed a good sized meat last thing at night, so his stomach acids have something to work on over night.
7. 1 to 2 drops of phosphorus twice daily on one day weekly, see below.
From reviewing the form I had filled in, Nick is still await for Ted’s clinical records/history from my vets. His observation today he categorized Ted as a “Phosphorus Personality Type” and prescribed 1 to 2 drops of phosphorus twice daily on one day weekly, he gave him his first drop today with instructions to administer am and pm on Sunday. He thinks the nervous tremor may disappear with the raw diet and the phosphorous drops. Nick gave me two suppliers to contact for the raw foods, so need to order them, but need to get an additional table top freezer because you have to place a minimum order quantity, so will have to get one of those this weekend or at least shop around for one. He recommended a book: Raising Cats Naturally by Michelle T. Bernard (ISBN 978-1-4276-0534-4) and showed me proof that cats do not need vaccinating every years, every three years is best and recommended I look at WSAVA vaccine guidelines. Nick will call on the following days: 25th august, 1st Sept, 8th Sept and an appointment has been arranged for 15th Sept, for an assessment in Bath again. www.holisticvet.co.uk/
August 30, 2011: I sent Nick Thompson an email saying that I will keep Teddy on what he is on at the moment and cancelled the appointments. I found out that phosphorus acts on the cats parathyroid gland and needs to be carefully balanced, so I am very uncomfortable with this. I did not give Teddy the phosphorus yesterday just in case. I had enough of that with Gismo’s hyperthyroidism. I also found out that Zantac 75 is safe which can be given twice daily. Teddy is much better on this medication and dose. Also, as IBD is a chronic illness, perhaps this is as good as Teddy will get. He is much, much better eating the food he is on now, compared to how he was last year, so perhaps will not rock the boat for now. I had a very nice reply from Nick Thompson when I cancelled the appointments. He totally understands why I will continue with what Teddy is on for now, because Teddy is stable. He said I can always contact him again if I need to. So I’m pleased I did not offend him because his very well qualified and he was so gentle when he examined Teddy. I could tell he genuinely enjoys being with animals, so I think his intentions are good. On reflection I don’t think the phosphorous would have had much of a negative effect on Teddy, because it was a weak tincture mixed with spring water and Teddy would only have had two tiny drops once a week. So it was a very minute dose, once weekly. It was my fear of making Teddy’s health unstable that made me decide not to go down that route.
October 24, 2011: Teddy and Lulu went to the vets today for their flu jabs. I’m having a biochem of their blood done, so we have a better understand of their body chemist and how healthy they are. I talked about Teddy’s tremor and the new vet thinks it may be partial seizures, which we will discuss more on Wednesday when we have his biochemist results back, as it could be low potassium or another chemical. If not, the vet suggested an anti-epileptic drug called levetiracetam, she says that this is the best one as it has less side effects.
October 29, 2011: Teddy’s results were very good, the only exception was the urea which showed a slightly high protein level, which the vet thinks is due to slight dehydration at testing, and nothing to worry about. Ted’s weight has very slightly deceased, he is now 5.82 kgs from just over 6 kgs before. I showed the vet some mini videos of Teddy’s tremors and she says it is focal seizures and will look into the correct dosage of a drug called levetiracetam. They stock it but in dog size, she says it is very safe on the kidneys and liver and no adverse effects it is stopped suddenly, she said it was a third generation drug and very safe and that is why it is so expensive (£7/ $11 per tablet, excluding vat at 20% ) it is used in humans. She says focal seizures do not cause any pain or discomfort and it would be best to try levetiracetam for a month and see how he is on it, although it will make him a bit drowse. The cause is most probably idiopathic caused by random electric impulses sent from the nerve cells in the brain to muscles in the body and that is what causes the involuntary movements and tremors. The vet will let me know the dosage and cost towards the end of next week, but by trying the drug and assessing the tremors it will give an indication of most probable cause or at least rule one out. The vet wants me to try and monitor the number of occurrences per day and to be aware if any increase in occurrence, severity and duration and to email her addition mini videos so she can monitor his progress and further access him.
November 18, 2011: Teddy had a consultation with the vet today. She gave him a examination specifically to see how his facial nerves respond to touch and to see his focal response to items moved in front of his line of vision. Also to see if his pupils react to light in a darkened room (they remained dilated because Teddy was scared at the vets). She also moved his head left, right, up and down to assess his alignment, movement, location, in relation the position of his head, spine and muscles. Three mini videos of Teddy’s tremors are being forwarded to a feline neurologist for them to have a look at and advise on. The vet mentioned the possibility of Teddy having toxoplasmosis, as this can sometimes cause problems in the brain and nervous system in cats, but we will wait for the neurologist’s feed back first. Then if necessary we will carry out a blood test for toxoplasmosis, which is treatable with antibiotics, thankfully. So at the moment I am still waiting for my vet to let me know what the neurologist says. At the back of my mind I hope it is nothing more sinister, like inflammation or any thing like that in his brain, he is such a sweat heart and so precious. But apart from the tremors, he is a good weight, active, playful and very inquisitive. He’s like a little dog really, he follows me about everywhere in the house and the garden, and he always races me down the stairs and sit at the bottom looking up at me “like what’s taking you so long?” He has a good appetite and is very sociable, so it is probably harmless focal seizes.
December 9, 2011: The neurologist has looked at the videos of Teddy and is unsure of what the cause is. It could be focal seizes or some other condition, we would need to do more tests and it could end up being idiopathic, (no known cause). But both the vet and neurologist recommend that we try the levetiracetam for two or three weeks, as it will help us rule out if it is a neurological related problem. We are looking to start the treatment towards the end of December. The vet needs to order in a liquid form for Teddy as it will be easier to measure an accurate dose and easier to administer in this form. They currently stock it in canine size tablets which are way too big for Teddy and would be very difficult to cut down to ensure an accurate dosage size. The medication will take effect within two or three days and can be stopped immediately with not adverse effects if necessary, so I feel comfortable about this. If we see an improvement in the tremors then we will test for toxoplasmosis, as it is know to effect the brain in cats and cause seizures. If it ends up to be harmless and painless focal seizures after testing then I will not continue with the levetiracetam after the trail period, as I do not believe in over medicating, if their is no true benefit for Teddy.
January 5, 2012: On Christmas eve I noticed five or six stubbly finger like 1/1.5 inch swellings on both sides of Teddy’s back, below his back bone in his lumbar sections. I booked Teddy in at the vets on the 29th December for an examination. During his examination Teddy had a slight seizure, so the vet could see for himself first hand, which was brilliant. He thinks its harmless and painless focal seizures and that the seizures and swellings are not related, which its a relief. Teddy was booked in for sedative, ultrasound and fine needle aspiration of the swellings on his back for the next morning on 30th December 2011. Later that day the vet explained that the ultrasound did not show anything sinister and that he did not think it was anything to worry about but that it was best to wait till the sample results came back from the lab in the new year. The vet had taken several samples in and around the sample site to ensure an accurate result. The results came back today and they where just fat cells, so nothing to worry about thank god. Teddy started on Keppra 250mg tablets half twice daily on 30th December 2011. They have made him very sedated and dopey for the first four days, but had initially stopped the seizure. But as his character is returning so are faint seizures, so we will continue with the tablet for 3 weeks, then discuss with the vet.
February 2, 2012: Spoken with vet today, as Teddy has been on Keppra 250mg tablets twice daily for a month now. Discussed option of keeping him on them long term. However tablets not so effective as the weeks progressed. By third and forth weeks the focal seizures become more pronounced, so the only real benefit of keeping him on them was that Teddy was generally not so nervous as he normally is (a loud noise outside OR on the TV, he was not bothered, where as normally he would be up and look around OR runaway from the direction of the sound). Vet advised to observe and count the number of focal seizures Teddy has each day, for a period of over a month, then contact vet to discuss treatment option including testing for toxoplasmosis. Vet also explained that focal seizures are a form of epilepsy. I observed on average that Teddy has between 4 to 6 focal seizures per day (more or less, as I am not always around to count them). some are very faint and others more pronounced. He only has them while he is awake (thankfully cats spend up to 16 hours a day sleeping). Also most seizures only last for few seconds, some are singular and instant and others are a cluster of several small but more pronounced ones. Other than the focal seizures Teddy appears generally well, happy and content.
March 30, 2012: Awoke to find Teddy generally very unwell this morning. Tucked up and lethargic, not interested in food and diarrhea with fresh blood on his bottom, tail and litter tray. Teddy had passed 5 or 6 stools of diarrhea with mucus and bright red fresh blood in them during the early hours of the morning. It was so awful to see him like this when he was fine the day before. Thankfully I got an appointment with the vet straight way. The vet examined him and said that his large bowl was inflamed, that’s why there was so much fresh blood and mucus in his stools. It was colitis that had slowly built up over a couple of days, idiopathic or possibly stress induced. The vet examined both of Teddy’s eyes and by chance we saw the vet with a certificate in ophthalmology, who preformed an indirect ophthalmoscopy, with iris rubinosis and suspect chronic uveitis related to IBD diagnosed. The vet put a drop of Atropine eye ointment into each eye to dilate the pupils, as this condition can cause the pupil to become permanently small. The vet explained that the ointment would help to detach the front of the eye from the back of the eye, as sometimes this condition causes the eye to stick together and can cause pain and loss of sight. I had no idea that his eyes were so bad. The symptoms are: redness of the eye (which you can’t see in cats, they do not have a visible white eye section of the eye like humans do), blurred vision, sensitivity to light (photophobia), dark floating spots along the visual field and eye pain. The vet said it is not easy to detect. Thank god we saw this vet today or I would never have known. The vet said that epilepsy can cause damage to the retina at the back of the eye too.
A blood sample was taken to test Ted for pancreatitis (pancreatic lipase) and toxoplasmosis (IgG and IgM) also B12 /folate B3 with results due back over the next couple of weeks. Teddy was prescribed 1 & 1/2 metronidazole tables (50mg) twice daily, to reduce the inflammation in the large bowl (antibiotic and inflammatory). 0.2 mls Vetergesic three times daily for pain relief and 1 drop of Maxitrol ointment in each eye twice daily for his eyes. Also advised to continue with 1/4 Zantac twice daily and 4 pouches of Royal Canine sensitive control chicken and rice pouch food to help with is tummy and to encourage him to eat as he has lost weight. He is now 5.3 kgs (> 0.6kg) from 5.9 kgs. By bedtime today (within 12 hours of seeing the vet) Teddy is so much better. He has eaten and is generally more like his usual self. He will have dilate pupils for days and is drowsy from the pain relief, but its so wonderful to see such good and quick response, thanks to the medication and the vets advise.
March 31, 2012: Teddy going for strength to strength, much better today. Pupils still dilated, eating well, 5 or 6 small meals in the day of the pouch food with fresh cooked chicken breast mixed in. So lovely to see him improve like this. Next appointment booked for April 16th to examine his eyes again. I was very upset about his eyes being effected, hopefully we have caught in time. But the vet has described it as chronic not acute, so we should know more when he is examined on 16th April. Lulu is booked in then too for a toxoplasmosis blood test and to have her eyes expertly examined also. The vet also suggested having both cats tested for Feline leukemia and feline aids.
April 7, 2012: Finally got Teddy’s results today, he has been diagnosed with pancreatitis. The pancreatitis test results came back as 6.2, with the normal range being between 0.1 and 3.5. I asked how best to treat and if he needed more medication, but the vet said that you can’t treat it with medication, other than what he’s on and it is best managed with a bland, low fat diet. The vet recommended Royal Canin Sensitivity Control, which he has been on since this bought of illness started a week ago. I added 50% lightly cooked chicken breast to it, so that he has more goodness, but really don’t what to keep him on it all the time, it contains sugars, etc. There was some good news too. Teddy tested negative for the toxoplasmosis, which I was very surprised about and leaves me puzzled as to what has caused the seizures. Will definitely ask about the Gabapentin and try and get him on it. Teddy’s results for B12/folate were very good, 950, where as a normal count is at the top end is 440, the vet was very pleased with this.
April 16, 2012: Teddy went to the vet today, the vet examined his eyes again due to the iris rubinosis and uveitis, and observed the area of his iris in both eyes is less red and more brown in color, which indicates they was getting better. But Teddy will have to continue on the Maxitrol (steroid) eye drops permanently (twice daily in both eyes). His weight is the 5.3 kg. Blood test taken for FELV and FIV.
April 18, 2012: Teddy’s FELV (feline leukemia virus) and FIV (feline immunodeficiency virus) results were negative, which is excellent. Appointment for addition testing, including possible MRI (1.5 Tesla MRI) for the focal seizure (possibly petit mal) and consultation to be carried out on 26 April 2012 at a University hospital.
April 27, 2012: Teddy was examined by a senior veterinary medic and European specialist in veterinary neurology at Langford Hospital, subsidiary of the University of Bristol on April 26th, 2012. Although epilepsy was initially suspected, clinical observation indicated facial twitches and a very mild head tilt on his left side. Although epilepsy can not be ruled out, the clinical signs do not quite fit with seizures. Ted’s twitching effects both sides of his face and are random in effect (sometimes his right eye and whiskers , some times both eyes, and other times his left eye, sometimes just his whiskers twitch). If it was ‘petit mal’ (focal seizures) then only one side of his face would be effected in relation to which area / side of the brain was effected (external right side twitch = left side of brain and visa versa). If Ted had ‘grand mal’ seizures then both sides of his brain would be effected and this would usually present as a full seizure. MRI was not carried out because it was thought that the MRI would most probably be normal at this stage, and the long duration of fairly stable clinical signs makes a more sinister underlying problem less likely. Advised to continue monitoring, and MRI could be carried out in the future if necessary, with no medication required for his facial twitching.
During examination Teddy had a mildly increased blood pressure (162 mmHg: normal is less than 150 mmHg) and a fast heart and breathing rate (but he had been traveling by car for 3 hours, prior to examination and testing). Blood tests were taken for bile acid, biochemistry, full hematology and T4 (thyroid). Results revealed his kidneys were fine, his liver enzymes were slightly elevated. Although lower than when last tested during his recent bout of pancreatitis. So they are coming down and heading in the right direction. Ted’s T4 result was 45 or 46, so possibly hyperthyroid with the range going up to 65, but most cats are within the 15 to 20 range when the thyroid is normal, so need to retest in 4 to 6 months time and treat if hyperthyroidism is diagnosed. Senior veterinary medic said Ted was in good condition for a cat of his age with a history of IBD which was very pleasing. Slight water stain effect at the back of both eyes was seen during examination, advised to book an appointment with an ophthalmologist for further investigation /examination. Ophthalmologist appointment booked for May 23, 2012.
May 23, 2012: Teddy was seen by the ophthalmologist on Wednesday. The uveitis is under control with no inflammation in the eyes at all now, which is excellent news. Both retina are fine, healthy with no bleeds or inflammation. Advised to reduce the Maxitrol eye drops from twice daily to once daily over the next two weeks, then to leave untreated for two weeks prior to Ted’s next appointment on June 20th 2012. The ophthalmologist noticed that Teddy has a ocular abnormality in both eyes like a spider web effect of suture lines, which I was able to see in the consulting room with the use of her equipment. Normally they are like a faint Y shape at the front of the eyes and an upside down Y shape at the back of the eyes, but Ted’s were just like a sparking white faint spiders web, beautiful to look at, but would effect his eyesight. The ophthalmologist said that they were most probably formed like this when he was still in his mothers womb, so he will not be aware of any sight abnormality, he will see things as he has always seen things. I read that eye abnormalities like this can be linked to hyperthyroidism, when he was at Langford hospital last month they advised to retest for hyperthyroidism in 4 to 6 months. So I will keep this in mind and mention it at our next ophthalmologist appointment, just in case the suture lines are getting progressively worse. I trust my own intuition now too. Ted also has faint speckled effect on both of his iris, but nothing to worry about as they are only small and not linked together, but will monitor them too.
May 29, 2012: I noticed Teddy was squinting in both eyes this morning and had slight mucus too, also painful and sensitive to light. Vet examination diagnosed ulcers in both eyes, the left eye is the worst with 60% ulceration. Hospitalized overnight, with 0.2 ml Vetergesic given for pain and Chloramphenicol eye ointment and Viscotears to lubricate. Possible cause of ulcers, chemicals burns, unknown source of chemicals, except soda crystals or possibly jet wash spray from our neighbor drive cleaning exercise the day before. Both eyes examined by ophthalmologist on 30th May, observed both eyes beginning to heal nicely, so will continue with supportive therapy, allowed home wearing an Elizabethan collar, so I have two of them in these collars now including Lulu. Re-examination, 30th June, diagnosed NO improvement since last examination, 30th May, therefore prescribed 2 units of Metacam (normally for his weight, 5 kg, it would be 5 units, but because of Teddy’s IBD a low dose is given to help reduce the inflammation in both eyes) and Famvir tablets 1/4 twice daily.
Because Teddy’s eyes are not healing and are so painful the vet has prescribed an antiviral drug used to treat feline herpes virus -FHV1, to ensure all areas are covered and he should get better quicker. Not sure if he has the virus but anything that get him better soonest is good with me. Its hard going to get all his treatments in because the Vetergesic is every 8 hrs. (3 in 24hrs), the Chloramphenicol is ever 6 hrs. (4 in 24hrs), the Viscotears are every 6 hrs. (4 in 24hrs) and must be given 10 minutes after the Chloramphenicol, prior to the administration of the eye drops I have to wipe his eyes with cooled boiled water to remove any discharge (4 in 24hrs) and the Famvir 1/4 tablet every 12 hrs. (2 in 24hrs) and the Metacam once daily only. So, I’m not getting much sleep as I have to administer 14 treatment and 4 eye bathes every 24 hrs. It could take as long as 6 wks. to get him better, but anything is better than seeing him like this.
June 7, 2012: Ophthalmologist examined Teddy’s eyes today which revealed that his eyes are healing very slowly, his left eye is still worse than his right and may prove a problem to heal, as they really should have been nearly completely healed or at least well on their way to healing within just over one week of supportive therapy. The left eye is now approximately 45% ulcer instead of 60% and may prove to be a non healing ulcer. This is very bad new as it may need surgery to help the cornea to fully close over, but we will have to wait and see how the healing process progresses. My vets have ordered in L-lysine paste for me to try him with as another means of supportive therapy. Hopefully I can start him on it later today. It helps in the control of the feline herpes virus, because it surpress viral replication. We are not sure if he has herpes, because he does not have any of the other symptoms, also the ulcers came on very quickly, over night and have effected both eyes, so it could be from my neighbors jet washing the evening before the ulcers appeared, the ophthalmologist said that even faint dust and dirty from the mist type water stray could have triggered it, but in an effort to get him better soonest we are giving all the supportive therapies we possibly can in order to increase the chances of recover. He is still on the same quantity and type of medication as before, with just the addition of the l-lysine. Next appointment with ophthalmologist booked for June 13th 2012.
June 13, 2012: Good news Teddy’s eye ulcers have healed with just a small area of erosion about 6 mm x 4 mm in each eye that still requires supportive therapy. So we will continue with the Chloramphenical and Visco tears three times daily (every 8 hrs instead of every 6 hrs) , L-lysine twice daily for two / three months and Famvir tablets twice daily for the next 4 days. We have booked appointments with the ophthalmologist for 20th and 27th June for repeat check-ups, also if the eyes have not totally healed in the next two weeks then they may still need surgical help in closing the erosions. But really do not want to do that if possible because it would compromise his sight in both eyes, so paws crossed they continue to heal. I was dreading the outcome of Lulu’s results and the status of Teddy’s eyes but now I’m sooooo happy that it is such good news, even if we still have a little way to go, I will try and get both of them on a immune system supportive supplement when they are both better.
June 15, 2012: Friday June 15th, 5 am, Teddy’s vomited up his supper from the night before. He vomited again at 9 am, so I switched from ZiwiPeak lamb, to home cooked white fish and he ate small two meals and kept them down at 2 pm and 7 pm. I decided to stop administering Enisyl – F (L-lysine) as Teddy always licks his lips after each application, as if he is feeling nauseous. He seems to be tucked up in his manner, so I gave him 0.2 ml Vetergesic at 9.30am which seemed to settle him down nicely for the remained of the day. He was ok the next day (16th), but the day after (17th) he vomited up his supper from the night before, again at 5 am. He ate three small meals during the day of home cooked white fish. He finished his last Famvir tablet today (14 days of treatment) but seamed tucked up again and sensitive around the tummy area when groomed in the evening so gave him 0.2 ml Vetergesic at 10.15 pm. He was much brighter after that and passed a very hard (rock hard) small poo, which I saved (double bagged) for the vet to check out in the morning.
Monday June 18th vet examination and explained that Teddy’s bowel was fully compacted with hard poo up to the small colon, the bend in the bowel towards the stomach and panaceas, which was causing considerable discomfort. Not sure if pancreatitis, as the pancreas did not feel inflamed. Most probably the compacted poo is causing pressure and pain. I decided to treat with Zantac and Losec just in case, as it will help him feel better, Vetergesic three times daily for the pain and lactulose for the constipation 2 ml twice daily. Teddy had an enema at the vets too. Tuesday June 19th not interested in food, and no poo again, still on white fish.
June 20, 2012: Ophthalmologist examined Teddy’s eyes today, both are getting better with only 6 % instead of the original 80 to 90% of his cornea affected now, which look like little spots on the cornea. One spot in one eye and three spots in the other eye; still may need to surgical procedure to close the erosion in the eye with three spots though. Advised to reduce the Chloramphenicol to twice daily instead of three times, but keep Viscotears the same (3x daily) and add Lacri-lube eye lubricant twice daily, mid morning and evening; reduce Vetergesic from 0.2 to 0.1 ml once daily as it may be causing the constipation, as opioids can cause constipation. Vet examined his body and said that the compacted area was greatly reduced, probably only half way now towards Teddy’s lower end, so keep him on moist food. I decided to stop the Vetergesic from now onward, instead will gently massage his tummy, but he is not interested in food, vomited up liquid food and did not poo again today.
June 21, 2012: Back to the vets, Teddy seemed tucked up with no appetite and no poo again. Vet examination revealed a very hard compacted area in his bowel, so gave him an enema again and one Microlax enema for me to give at home if he does not poo within the next 4 days. Back at home he did not have any appetite but passed a small hard poo at 10.30 pm and vomited again at 11 pm despite still being on Zantac, Losec and lactulose, daily. June 22nd no poo and no vomit, June 23 one large poo and one attempt to vomit, June 24 no poo and one vomit. June 25 to 27; no poo, no vomit, as last natural poo was 4 days ago. I gave him an enema at 9 pm on June 27 and he passed a normal sized hard poo. June 28, vomited up a very hard fur ball this afternoon. He is still wearing his collar for his eyes, poor darling has problem both ends, but is SO good-natured despite having to be daily dosed with 12 applications of treatments for his eyes, tummy and bowels. He looks very unkempt at the moment despite my best efforts to wash his face and groom his body, because the lactulose is so sticky and makes his fur clumped. And the Lacri-lube is so oily, he looks like a Teddy boy now with greased back fur, but he never complains. Next appointment booked with ophthalmologist on July 4th 2012.
June 27, 2012: Teddy has not passed a motion in the last three days so today being the fourth day, I gave him an enema at 9 pm this evening which worked within 10 minutes. He did not pass a motion naturally for another four days (Sunday July 1st), he also vomited 3 days out of the four days, but this was mainly due to fur balls. His system/ motions are coming back to normal now, as he passed a natural motion again today July 3rd and has not vomited for 2 days now. I feel so relieved and I suspect he does too.
July 4, 2012: Ophthalmologist appointment today, examination revealed that both of Teddy’s eyes are healed. There was no evidence of any damage to the cornea, which was a tremendous relief as it has taken 6 weeks of intensive treatment to get them to this stage. But we did it, without surgery too! Advised to continue with the Lucra-lube eye lubricant twice daily (am/pm), and reintroduce the Enisyl-F (L-lysine) one 1 ml pump (1ml = 250mg) once daily in order to continue the supportive therapy as Teddy’s eye have only just completely healed over. Suggested Zantac 2-3 times daily, as necessary. July 5th and 6th vomiting and nausea today, vomited up 2 large fur balls and I noticed Teddy is nausea after the Enisyl-F even if I give it after a meal. July 7th added Katalax 1” once daily for the next three days to help with the fur balls but vomiting still continued, sometimes without a fur ball. So on the fourth day stopped the Katalax and replaced the Enisyl-F with a pure form of L-lysine without any additives at 200 mg once per day from July 11th. Enisyl-F and Katalax both contain cod-liver oil and other flavorings. I think the cod-liver oil is probably aggravating his panaceas and causing the nauseous, so I have discontinued these, just in case. If the vomiting continues I will take him back to the vet, in case it is pancreatitis, but Teddy is generally very good in himself. His toilet is normal and he is very playful, so I will wait and see how he goes. Next appointment booked with ophthalmologist for August 1st 2012, for a check-up.
July 14, 2012: While gently grooming Teddy yesterday evening, he complained as I lifted him down onto the floor because he was tender around the upper tummy area, so I took him to the vets this morning, they could not find anything obvious wrong except an enlarged gland in his neck on his right side and slight tenderness around his stomach and pancreas area, all other areas okay including temperature. Advised to continue with the Zantac 3 x daily, give up to 3 on syringe of metacam once daily and put on a diet of home cooked white fish, while continuing with Katalax for the fur balls and lysine for the supportive therapy.
August 1, 2012: Teddy was re-examined today by an ophthalmologist. Both eyes look good, possible slight erosion in his left eye or it could even be a minute piece of dust or debris that has shown up green when examined under special light. Therefore advised to continue with Lacri-lube once daily, continue Zantac twice daily and the lysine once daily. Suggested another brand that may not make Teddy feel sick; Nutri-Science Lysine Aid Cat, salmon flavour, plus Katalax twice weekly to help control Teddy’s vomiting due to furballs. Teddy still being fed fresh home cooked white fish and Orijen kibble and sometimes Porta 21 chicken and chicken and aloe, which he loves. Teddy has a good appetite and is very happy in himself and only vomits once or twice a week due to furballs. Next appointment booked for October 3rd 2012, for a check up with the ophthalmologist.
September 17, 2012: Finally managed to get some lysine aid gel for Teddy, on Sept 12th started him on 1 pump per day. I will see how he goes on it as it has sorbitol and glycerine in its composition and I know how sorbitol stimulates bowel movements by drawing water into the large intestine. Continued with home cooked white fish, orijen kibble and Ziwipeak lamb canned food daily. Reduced Zantac to only occasional use as needed. I started Teddy on 1/2 tsp of slippery elm bark power (Dorwest Veterinary Tree Bark Powder) per day mixed in his food on Sept 15th after reading a lot about it and its benefits of soothing the entire digestive system, helps slow the passage of food through the digestive tract and can be given indefinitely for conditions such as pancreatic insufficiency. It is very safe with no known side effects. I decided to give it as support for his IBD and prevention of pancreatitis but also because I have a feeling that his facial twitches may be caused or at least exaggerated by possible tummy spasms. The reason I feel this is that I am taking short-term medication myself that is causing tummy cramps/ spasms and I have been flinching with the spasms similar to Ted, so I thought it is worth trying it to see if it helps him in anyway. Also my cousin was recommended it by her consultant for her irritable bowel.
October 11, 2012: Very pleasing outcome to ophthalmologist’s examination of Teddy’s eyes today. Both eyes are totally healed and he no longer requires any eye drops or ointments. Advised to continue with the L-lyinse Aid three times a week as a supportive therapy, especially during times of stress. I got the vet to check Teddy’s ears too, as I noticed a small grayish black pigment patch on the inside section of his right ear. The vet says it could be ceruminous adenoma and that adenocarcinoma is less likely. She looked down each ear canal to see if there were anymore but it seems to be just in the one place and is approximately 2 mm in width. So advised to monitor the growth of the patch and contact the soft tissue surgeon if it gets any bigger or if other patches begin to appear, so that it can be easily removed. Apart from the above Teddy’s health is generally very good. The Lysine, slippery elm bark powder and ZiwiPeak moist food are having an excellent effect on his general well being. His coat is amazing! Silky soft, shiny and vibrant colors, he looks the best he has ever looked. His weight has improved to 5.5 kgs and he does not vomit at all now. No longer needs Katalax for fur balls or Zantac and is generally much happier in himself too. I continue to feed him Orijen kibble, Porta 21 pure chicken and home cooked white fish too, but ensure he has ZiwiPeak canned food twice a day. Ted had his yearly boost and health check on October 18th.
January 4, 2013: I noticed Teddy had been scratching his ears with his back feet and occasionally pulled out clumps of fur, so I took him with Lulu to the vets. Vet examination revealed his skin and ears where very clean and did not show any signs of mites or infections, most probable cause, molting, due to central heating during the cold weather. The vet checked down both ears, as I worried that he may have more grayish black pigment patches developing down the ear channel, where I could not check, but there where lovely and clean and clear. All other aspects where fine too.
April 18, 2013: Teddy had his eyes examined by the Ophthalmologist on April 17th because he had been squinting in strong sunlight, which could indicate he has a re-occurrence of uveitis, but the examination resulted in both his eye being healthy, with no evidence of inflammation of the iris or retina, no flare in the canal and his eye pressure was 11 and 12, which is normal, which I was relieved to hear. Teddy had a dental examination on April 18th which revealed slight build up of tarter, no evidence of plague or gingivitis and his gums are nice and healthy, therefore he does not require a clean, de-scale and polish at this stage, the vet recommend having another dental in 12 months to reassess the situation, the reason his teeth are in good condition for his age is because I brush them every other day.
August 29, 2013: Ted managed to sneak a blob of butter and a few potato crisps I dropped on the kitchen floor before I had time to clean them up, Ted done the job for me! Prior to this Ted had experienced fur balls for a few days. Within 12 hours of eating the items Ted looked unwell, was not interested in his food and seemed a bit tucked up, all other area okay, his toilet was normal and no vomiting. I booked an appointment with the vet but could not get an appointment till later in the day, so I gave him 1/4 Zantac in the morning, and checked on him in the afternoon. When I returned in the afternoon, Ted was back to normal again. But I still kept the appointment with the vet, just to be sure. The vet examined Ted and said that the potato crisps had probably caused stomach cramps as they contain gluten, and that giving him Zantac straight away was the best thing I could have done; recommended Katalax for the fur balls and advised to keep him on a bland diet of home cooked chicken only and continue with the Zantac for 2 to 3 days. During the consultation I asked if there was a natural alternative to Katalax as it contains petroleum jelly and I don’t really like giving him that, but the vet said they did not know of any, that it was safe and suitable for cats. I followed the advise and Ted continued to remain well, but It just goes to show how essential it is to keep to a strict diet of top quality food for an IBD kitties’ health and welfare; also, thanks to Lisa’s newsletter I now know there is a safe nature remedy for fur balls:- egg yolk lecithin, so I will give him this in the future instead of the Katalax, Thank you Lisa.
September 25, 2013: Ted had diarrhea with fresh bright red blood this morning, was otherwise okay. A bit off his food, but was not vomiting. Vet consulted, Ted examined, given steroid inject to cover 48 hours and prescribed 1/2 Metronidazole 200mg tablet twice a day for 5 days. Advised to collect toilet sample if still not settled after his treatment. Toilet sample taken to vet to test 3 days after his treatment had ended because his toilet was still very soft. Although greatly improved, and I thought I saw a faint smear of blood in it. Spoke to a vet while handing-in the sample, vet said it is not unusual to see blood in the toilet with IBD, so not unduly worried about it, did not recommend giving more steroids so close to the initial injection. Advised not really worth sending the sample off for analysis because the antibiotic treatment would give an inaccurate result as it effects the guts natural flora, and would only need to test for parasites if symptoms continued. Advised to try Ted with Canikur Pro (15ml) 1 ml twice a day to help the gut restore its natural balance or possibly try Pro-Kolin+, if Canikur Pro not successful. Also keep on a bland diet of home cooked chicken. Within 4 hours of first 1 ml Canikur Pro treatment, Ted very eager for his cooked chicken breast, with 24 hours Ted’s toilet back to normal, no blood at all. Its amazing how quick this stuff works in conjunction with a good bland diet. At end of Canikur Pro paste, 7.5 days later, Ted back to his naughty, normal, chucky self again, thankfully.
August 24, 2014: Teddy visited vet today due to soft poo with blood, no vomit. Vet prescribed metronidazole 200mg half tablet twice daily for 5 days. And I fed him exclusively on lightly cooked chicken, at end of treatment Teddy back to normal on August 29, 2014.
September 5, 2014: Teddy wormed with Panacur Paste 18.75% in a syringe to give 1ml per Kg body weight for the next 3 days.
November 17, 2014: Wormed with Panacur Paste 18.75% in a syringe at 1ml per Kg body weight for the next 3 days because my three little darlings found a mouse in their enclosure and ate it, (not best pleased!!!) so dewormed just in case, to stop possible Giardia spp infections.
December 10, 2014: Prior to today (10th Dec) Ted vomited on 16th and 20th November, the day before and after Ted was wormed, and on 21st Nov. So I fed him exclusively on lightly cooked turkey breast and Orijen kibble and started him on 1/4 Zantac each morning. Which resulted in three consecutive days without vomit; one with vomit and another two days without vomit. Other two days with vomit, a total of eight days on Zantac. With vomit occurring on three separate intermittent days till on 30th November when he vomited up a 1 inch solid plug of fur. So I kept him on Zantac for another five days, (till 6th December) to settle his tummy as he had a bit of gas and indigestion. No vomit or Zantac for the last 6 days, still feeding Teddy lightly cooked turkey breast and mainly Orijen kibble, tummy is fine on this.
December 11, 2014: Teddy had Nobi-vac Tricat Trio vaccination today and health check up, heart and lungs all sound clear and healthy, weight 5.6 kg. Teeth and eyes are fine too, no obvious problems observed during this consultation, vet very pleased with his condition for his age.
June 5, 2015: Teddy normal until jumped off bed in afternoon, limping in back right leg, leg shaking with pain and Ted in distress and crying a lot – got emergency vet appointment. Vet first thought it maybe a blood clot in the leg or a possibly a bone fracture. Put Teddy on oxygen in case the blood clot traveled to him lungs, also for the pain and because it could be a critical situation. The vet checked both hind legs for a pulse at various point in each legs and checked his heart for a heart murmur to rule out a life threatening blood clot. Thankfully there was a pulses in both legs and no heart murmur, so no blood clot – very scary to see him like this and while waiting for the outcome. Next both legs X-rayed, both legs showed signs of arthritis, which is normal in a cat of his age, but the right hind leg had three abnormal / unusually shaped bone over growth formations, but no fracture. Allowed to go home later that day with pain relief, tramadol 10 mg twice daily due to IBD, advised strict bed rest and check-up in 3-5 days depending on how the leg improves.
June 9, 2015: Phoned vet am to asked if Teddy could have vetergesic instead of tramadol as he had not eaten much for days, tramadol was making him feel sick and spaced out, also as not much going in, not much coming out either. Vet advised 0.3 ml twice daily and made appointment for later that day. In the evening we saw a different vet who assessed Ted. By now Ted was only slightly better, possibly 10% better, but still limping badly and clearly still in pain, unable to put any weight onto that limb. Vet suggest Teddy be seen by a specialist orthopaedic vet for further assessment and testing to be carried out in case of hairline fracture. Teddy starved overnight on Thursday 11th June 2015 for anesthetic the next morning.
June 12, 2015: Teddy admitted, a series of X-rays taken, approx. 8 or more in different positions, with good leg x-rayed for comparison. Physical examination revealed some instability in the joint possibly caused by a tear in the intertarsal ligament. Fluid collecting in the joint, twice as much fluid at the comparable leg join. X-rays revealed the hock/ ankle joint bones where not lined up and not connected, with a sizable separation of the joint due to a tear in the ligament. The intertarsal ligament normally hold the hock bones in place and make the joint secure. The bone within the joint area, three bones in total, showed signs on abnormal over growth of bone and the joint was inflamed and infected, however there was no sign of an external injury or a possible entry point for the infection to enter the joint which puzzled the vet. The joint was infected but we do not know where the infection has come from. Vaguely possible that inflammation and bacteria in gut from IBD has circulated in the blood stream and settled in the joint, but not necessarily the case. We do not know how long the infection has been there for either. Also not sure if new overgrowth of bone is osteoarthritis or a form of cancer from the x-rays as the overgrowth is an unusual shape.
Later in day the joint was opened and flushed out to remove the infection, the joint was surgically pinned with 5 separate steel rods so the joint can become solid and stable in time, as unable to repair the intertersal ligament directly but the joint would be solid and secure with 12 weeks of bed rest and the pins in place, so Teddy will have to stay in a large dog crate for most of this time to rest and help it heal, definitely not able to jump as it will damage the joint further. Hock joint fluid needle aspirated and examined in-house, highly probable inflammation and infection main cause of abnormality of hock bones and joint, which has weakened the joint and Teddy using it has cause the tear in the ligament. Three biopsies taken, one from each abnormal bone in hock, sent off for histology with results back by Thursday of next week, with possible cause of over growth of bone due to infected bone or a form of bone cancer.
June 13, 2015: Collected Teddy at lunchtime, he was able to stand on all four legs but is very spaced out on the vetergesic 0.3ml x 3 times daily and cries a lot, does not like being in the cage, not interested in food either which is very unusual for Teddy as he is normally a real foodie. I have given him his favorite food and lots and lots of love and he has finally settled, but I expect he is wondering what on earth has happened to him poor little boy. He is on half a 250 mg tablet of Claveseptin twice daily and vetergesic 03ml three times daily. His leg is bandaged, with the bandage being removed on Monday evening and a check up with the orthopaedic vet of Thursday evening and histology results then too. I can’t believe how quick this has come upon us, Teddy was normal this time a week go, but it just goes to show how quickly things can change as he must have had that infected joint for some time without any obvious outward sights or at least he never showed me any or I would have acted sooner.
June 15, 2015: Vet check up and removal of bandage, nice clean leg revealed. Still on same dose of medications, no poo for three days now, otherwise okay and eating well.
June 16, 2015: Still on medication, eating well in morning, but vomited up his supper of cooked chicken in evening so gave 1/4 Zantac. Seemed depressed in evening.
June 17, 2015: Still on medication and Zantac twice daily, not interest in food but generally okay and bright all day. I spent all day with him out of his cage, I have to watch his every move as he is still very quick but must not jump at all. Eating better in evening, no more vomit.
June 18, 2015: Vet check up and histology results which were all good. Arthritis, infection and inflammation are the cause of the abnormality of hock bones and joint. Leg examined and all clean and tidy, Teddy is such a good boy, he has left the leg alone and has not needed to wear a collar. Another seven days of antibiotics prescribed and advised to reduce the Vetergesic to twice daily until Sunday evening, which will be his last dose, but can reintroduce if his leg is still painful, keep on Zantac if necessary too. Next check up in seven days.
June 19 & 20, 2015: Gave 1/2 Claveseptin and 0.3 ml Vetergesic 12 hourly (8 am & 8 pm) and 1/4 zantac 8.30 am and 0.6 ml lactulose 8.45 am. No appetite today despite offering fresh cooked chicken, depressed in cage, happier on my bed with me – supervisor of course, as he must not jump or climb stairs. Normal toilet on Saturday, but appetite still not good offers small quantity of tuna. Sunday same a last two days really.
June 22, 2015: Gave 1/2 Claveseptin 12 hourly (8 am & 8 pm) and 0.3 ml vetergesic at 8 am because I will be away all day and feel happier knowing he has pain relief while I am way. Depressed in cage, happier out and when I am with him.
June 23, 2015: Vomited up breakfast straight after eating it, medication as above but added 1/4 Zantac 8.30 am. Phone vet to ask for some losec (2 x 10 mg 1/2 once daily), started him on this in evening 8 pm, gave 0.6 ml Lactulose at pm in case no appetite caused by constipation or nausea. 11 pm regurgitated supper of white fish immediately after eating it. Very quite – depressed, nauseous , but not licking lips to indicate nausea.
June 24, 2015: Ate small quantity of chicken overnight 8 am possibly 3 tsp., 8 am & 8 pm 1/2 Claveseptin, out of cage for most of day, 3 pm 0.8 ml lactulose, 7 pm 1/2 losec. No appetite all day, 7.30 pm ate small quality of freshly cooked white fish, generally happier today, but no poo for 4 days now.
June 25, 2015: Overnight teddy produced a very hard and dry poo. 8 am and 8 pm 1/2 Claveseptin, ate small quality of fresh cooked white fish am, 10 am 0.8 ml lactulose. Depressed with poor appetite. Check up with specialist orthopedic vet 5 pm, the surgical procedure/ treatment Teddy had to his leg will result in Peri-articular Fibrosis of the joint. A scab was removed from one leg pin, all others nice and clean with no issues as Teddy is able to put full weight on leg and walk normally with it. Temperature normal, enlargement of kidneys found on examination, possible cause infection, inflammation or kidney disease. In case of kidney infection additional 5 days of 250 mg Claveseptin prescribed and booked to see specialist renal vet on Monday morning to have blood test and an aspiration of renal fluid. Another check up with orthopedic vet in one week, with possible pins out in 4 weeks, if leg stable and cage rest for another 2 to 3 weeks after to ensure the joint has time to close up the hole and become permanently repaired prior to Teddy using it for normal activity like jumping onto window sills etc. Renal specialist is 90% sure Teddy has lymphoma of both kidneys. Teddy has blood tests carried out and urine sample and ultrasound scan of kidneys this afternoon. We have to wait for the lab results tomorrow afternoon but specialist feels they will confirm his suspicions.
Treatment Options: Steroid only to support him, palliative care – he may last 1 to 2 months
Madison chemo – at best 5 – 6 months
Cop/chop – at best 5- 6 months
Of course it is only their opinion and he may live longer or shorter than the average. All this and he will have to have his leg in the structure for another 4 weeks – unless they decide to shop that treatment.
June 26, 2015: Gave am meds 1/2 Claveseptin, ate little and often throughout the day, 14 teaspoons of white home cooked fish at 2 to 3 hour intervals. Slept most of the day on the bed, cuddle with me on the sofa in the evening, slept through the night too.
June 27, 2015: Brighter this morning, interested in food, gave am meds, ate 12 teaspoons of home cooked white fish throughout day at 2 to 2 hourly intervals, 1/2 claveseptin at 9 pm. 11.30 pm Teddy very interested in tuna, opened for little Lu, ate 3 teaspoons, 11.45 pm vomited it all back up. Ate nothing over night into morning.
June 28, 2015: Gave meds 1/2 Claveseptin at 8 am. 8.05 am ate 2 teaspoons of home cooked white fish, appetite good and drank some water. 8.15 am vomited it all back up. 8.30 am gave 1/4 zantac, 8.35 am drank lots of water, a saucer full – must be feeling sick and unhappy. 10.30 am gave 0.8ml lactulose in case of constipation, as it is the third day and no poo, last poo on Thursday and very hard and dry. Not sure if nausea or constipation is causing lack of appetite and sickness. Tummy making gurgling sounds in afternoon, generally unwell and lethargic, not wanting food or water at 1 pm – lunchtime. 2.30 pm ate 2 teaspoons of home cooked white fish.
June 29, 2015: Brighter this morning – out of over night cage and carried up stairs onto my bed at 6.30 am cuddled on bed till 8.30 am. Snuggled up real close and purred the whole time. 8.30 am gave 1/2 claveseptin and 1/4 Zantac. Fourth day and no poo. 9.45 am referral to European veterinary specialist in small animal internal medicine, physical examination of Teddy confirmed both kidneys enlarged and not constipated, stools in bowel soft to touch. Admitted for investigation of weight loss and large kidney. Ultrasound – both kidneys were very large with marked changes to the normal architecture. Fine needle biopsy (kidneys) – given the high suspicion of renal lymphoma, ultrasound sample from kidneys performed. Blood sample – suggested significant kidney dysfunction, likely to be secondary to the suspected lymphoma. Teddy kept in vets over night on fluids to ensure he does not dehydrate.
June 30, 2015: The fine needle biopsies have confirmed a diagnosis of Renal Lymphoma. Sadly this is a malignant cancer that cannot be cured. However, there are some treatment options to give Teddy some quality of life:
1. Palliative treatment with steroids (prednisolone) – this often has an excellent, albeit short-lived effect on lymphoma. With renal lymphoma the expected average life expectancy of 1-2 months using steroids alone. (Also to be considered steroid treatment would stop the healing process of his leg which still needs another 3 weeks to heal enough for the pins to be removed)
2. Chemotherapy – life expectancy is high with chemotherapy than with steroids alone, however, with renal lymphoma the average still remains relatively low at 4-6 months, a course of chemotherapy last 6 months, so Teddy would probably not finish the course.
Teddy given shot of steroid in morning and kept on drip all day for collection in evening. Whilst a treatment decision is made for Teddy, he has started therapy with prednisolone as this is likely to provide rapid relief of symptoms. Chemotherapy can be started at a later date if wished, but better to make the decision sooner rather than later or we will lose our opportunity. With this particular type of lymphoma almost 50% of cases will experience spread of the cancer to the brain tissue and therefore I was warned that I may see some symptoms such as seizure activity or change in behavior as this condition progresses. I asked if Teddy was in pain, the specialist said Teddy did flinch when his kidneys where examined, so they are probably sore, but lymphoma generally gives flu –like symptoms. Advised with this type of cancer it is not expected that Teddy would die naturally in his sleep, so at some point he would have to be put to sleep to ease his suffering.
On arrival home – Teddy clearly happy to be home, but house very warm, hottest day of year so far, opened all windows – not wanting him to dehydrate again, used small fan in bedroom to keep him cool, gave half a 5 mg prednisolone tablet, started in evening at 9 pm. Ate several small meals of home cooked white fish, but generally very unwell, wanting to lay in cool corners of house where wall vents are, for cooler night breeze. Bed time, I took him to bed with me and had fan facing him all night, we lay on the bed together, both Teddy and I awake all night, I watched him all night terrified he would jump off the bed and go down the stairs while his leg is still mending and injury it more, can’t bear to put him in the cage, I want whatever time his has left to be nice, I tried sleeping on floor besides him with the cage door open, but Teddy just wants to go upstairs on my bed with me. However when upstairs Teddy did not sleep because he was restless, he only settled from 5 am to 7 am onward – restless and hot – fan on full and offered water frequently.
July 1, 2015: 8 am 1/2 prednisolone given, lethargic and wants to be left alone. Brighter in afternoon, ate some freeze dry chicken treats, than later ate home cooked chicken at tea time. 8.30 pm 1/2 prednisolone given, less active – lethargic in evening, carried out into garden for 30 minutes – in cool evening air, content but inactive. No poo today. Bed time I took him to bed with me again and had fan facing him all night, we lay on the bed together, both Teddy and I awake all night. I have spend each waking hour since being informed of the outlook and options available to us, sobbing on and off and thinking about the best option for Teddy, also terrified that the cancer would travel to his brain. I wish I could ask him what he would want and I would do that gladly for him.
July 2, 2015: 2 am to 4 am Teddy restless in house – very hot, unbearable. 4.15 am to 5.15 am carried Teddy into garden, which he clearly enjoyed, the air was cool and full of bird song and he lay down watching the birds and chatting to them. 5.30 am diarrhea all down his bottom and furry pants in garden, he ran into house from garden limping. As I gently cleaned him up, he cried a distressing cry with pain clearly in his leg and when soft underside of tummy area touched, that was when I knew that things could not carry on any longer. I carefully placed him back in his cage from 5.30 am to 7.30 am terrified he would damage his leg further by using it to roam about, as he so clearly wanted to. Gave 1/2 prednisolone. Brighter after steroid but clearly still unwell. 8 am phoned vet cancelled check up appointment for later in day for orthopedic vet. Asked for a vet to do house call to put Teddy to sleep as I could not see him like this any longer.
11.30 am vet arrive to put Teddy to sleep, which was distressing as his paw was sore from the rehydrating on Tuesday, and the catheter hurt him and bled when it went in. He cried a lot and spat at the vet and nurse, but I held him gently in my arms and kissed his beautiful little face as he slowly went to sleep. I knew without doubt that this was the best option for Teddy as the chemotherapy would have involved an awful lot in intravenous treatments and he would have struggled and I did not want that for him. After he had been put to sleep the vet very kindly took Teddy back to the hospital for his pins to be removed, as I had requested, as I could not bear the thought of him being buried with those still in place on his deer little leg. While I waited outside for him, I gently carried him to the car and took him home where he belongs, to be buried. I feel very relieved that his suffering has passed now and so grateful to the vet for being so gentle and handling him with great care while alive and after too. But I know that the coming days and months will be empty without him as I have lost my soul mate who will never be replaced. The vet said he was a great little cat too.